37D2012812 CLIA NUMBER - WALGREENS #06436

Laboratory Demographics

  • CLIA Code: 37D2012812
  • Facility Name: WALGREENS #06436
  • Facility Address: 1400 E 2ND STREET
    EDMOND, OK
    ZIP 73034
  • Facility Phone: 405 216-9672
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DYLAN HANCIN
  • NPI Number: 1053326025
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 37D2012812
LAB Type Pharmacy
Facility Name WALGREENS #06436
Street 1400 E 2ND STREET
City EDMOND
State OK
ZIP 73034
Phone 405 216-9672
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/9/2025
Certificate Expiration Date 3/8/2027
Facility Type Pharmacy
Lab Director DYLAN HANCIN

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This page was last updated on: 9/29/2025